In numerous publications, the Indiana Health Coverage Programs
(IHCP) has reminded providers that correct rendering/group provider
linkages are essential to the proper adjudication of rendering
provider claims. Claims billed for services performed by rendering
providers not linked to the specific service location on
the claim deny for EOB 1010 - Rendering provider is
not an eligible member of billing group or the group provider
number is reported as rendering provider. Please verify provider
and resubmit.

IHCP policy requires rendering providers to be linked to the
specific locations where they render services for a group practice.
Further, a rendering provider's services may not be billed for a
service location to which he or she is not linked. Group
providers must ensure that the provider profile for each group
location has the correct rendering providers linked with accurate
effective and end dates.

In banner page BR201719, the IHCP
announced that EOB 1010 would temporarily be converted to a
"post-and-pay" status to allow providers time to submit enrollment
updates to appropriately link rendering providers to group
locations. A "post-and-pay" status means the claim-processing
system allows claims and claim details with this issue to pay, even
though the EOB 1010 message continues to post on the Remittance
Advice (RA). This temporary conversion was originally
scheduled to end as of August 31, 2017. The IHCP is extending this
temporary workaround through December 31, 2017. Effective January
1, 2018, the EOB 1010 edit will revert to a denial
status.

Providers should review their RAs in detail, note any EOB 1010s,
and update rendering providers in service location profiles, as
necessary. Providers are encouraged to submit these updates as soon
as possible to allow for processing before January 1, 2018.